AQA A Level Biology

Homeostasis (3.6.4)

Name: ______________________

Lesson My Marks Total Exam Homework Date

Question Checked
Marks
Lesson 1 – Importance of Homeostasis 31

Lesson 2 – Controlling Blood Glucose

Concentration

Lesson 3 – Adrenaline and Secondary

Messengers
Lesson 4 – Kidney Structure

Lesson 5 – Osmoregulation and ADH

Lesson 6 - Diabetes

End of Topic Test

 Specification Sections

3.6.4 Homeostasis is the maintenance of a stable internal environment

3.6.4.1 Principles of homeostasis and negative feedback (A-level only)

Content

Homeostasis in mammals involves physiological control systems that maintain the internal environment within
restricted limits.

The importance of maintaining a stable core temperature and stable blood pH in relation to enzyme activity.

The importance of maintaining a stable blood glucose concentration in terms of availability of respiratory substrate
and of the water potential of blood.

Negative feedback restores systems to their original level.

The possession of separate mechanisms involving negative feedback controls departures in different directions
from the original state, giving a greater degree of control.

Students should be able to interpret information relating to examples of negative and positive feedback.

3.6.4.2 Control of blood glucose concentration (A-level only)

Content

The factors that influence blood glucose concentration.

The role of the liver in glycogenesis, glycogenolysis and gluconeogenesis.
The action of insulin by:
 attaching to receptors on the surfaces of target cells
 controlling the uptake of glucose by regulating the inclusion of channel proteins in the surface membranes
of target cells
 activating enzymes involved in the conversion of glucose to glycogen.

The action of glucagon by:

 attaching to receptors on the surfaces of target cells
 activating enzymes involved in the conversion of glycogen to glucose
 activating enzymes involved in the conversion of glycerol and amino acids into glucose.

The role of adrenaline by:

 attaching to receptors on the surfaces of target cells
 activating enzymes involved in the conversion of glycogen to glucose.

The second messenger model of adrenaline and glucagon action, involving adenylate cyclase, cyclic AMP (cAMP)
and protein kinase.
The causes of types I and II diabetes and their control by insulin and/or manipulation of the diet.

Students should be able to evaluate the positions of health advisers and the food industry in relation to the
increased incidence of type II diabetes.
Required practical 11: Production of a dilution series of a glucose solution and use of colorimetric techniques to
produce a calibration curve with which to identify the concentration of glucose in an unknown ‘urine’ sample.

2
3.6.4.3 Control of blood water potential (A-level only)

Content

Osmoregulation as control of the water potential of the blood.

The roles of the hypothalamus, posterior pituitary and antidiuretic hormone (ADH) in osmoregulation.
The structure of the nephron and its role in:
 the formation of glomerular filtrate
 reabsorption of glucose and water by the proximal convoluted tubule
 maintaining a gradient of sodium ions in the medulla by the loop of Henle
 reabsorption of water by the distal convoluted tubule and collecting ducts.

GCSE RECAP

Principles of Homeostasis
Part 1 - Define homeostasis

Homeostasis is the regulation of a cell or organism to maintain stable optimum conditions in response to internal
and external changes. Homeostatic mechanisms are so important for your survival that they are automatic.

Our body has two main systems which it uses to maintain a constant internal environment:

 Nervous responses: These use nerves to transfer electrical signals from the receptors to the brain and
spinal cord (co-ordinators) and then to effectors.
 Hormonal responses: These use hormones which are released from glands and travel through the blood
stream to various effectors.

Part 2 - Why is it important to control your internal environment

Humans, like all mammals need to maintain a constant internal

environment. If our core body temperature, blood glucose levels, or
water levels change too much we can get very ill or even die. You have
learned that high temperature or extreme pH can denature enzymes -
break bonds causing their active sit to change shape. Enzymes are the
main reason for homeostasis.

Part 3 - Describe the key elements of control systems

Receptors in sense organs (ears, eyes, nose, tongue, and skin) detect a stimulus and send the information to
coordinators where the information is processed.

Coordinators are the brain, the spinal cord and the pancreas. Coordinators do not actually bring about the change
themselves – effectors do. An effector is any part of the body that produces a response.

Effectors are either glands or muscles which carry out the body's responses to stimuli. Muscles cause movement
(through contraction) and glands release hormones which bring about changes in the body. (response)

3
Hormones

Define a hormone

Hormones are chemical messages secreted by the glands of the endocrine system. Hormones are released directly
into the blood stream by endocrine glands, they travel to cells in the blood. The cells receiving the hormone have a
specific complementary receptor on their plasma membrane, which the hormone binds to. These cells are the target
cells.

Describe the main organs of the endocrine system

The pituitary gland is found in the brain, it controls many organs directly and
indirectly with hormones. It is therefore known as the master gland.
The thyroid gland produces thyroxine which controls the rate that glucose is
used up in respiration.
The thymus gland promotes the production of white blood cells
The adrenal glands produce adrenaline which increases heart and breathing
rate and raises blood sugar levels. These are essential for the fight or flight
response to danger.
The pancreas secretes insulin and glucagon to control blood glucose levels.
The ovaries produce oestrogen, progesterone and testosterone and control
female sexual characteristics and reproduction
The testes produce testosterone which control male sexual characteristics
and reproduction

Blood Glucose Control

Describe the role of the pancreas in monitoring and controlling blood glucose concentration

Insulin is the hormone that reduces blood sugar level. It is secreted and released by cells in the pancreas when they
detect high levels of glucose in the blood. Once insulin is released into the blood stream it’s target organ is the liver.
When the liver detects insulin it converts glucose in the blood into glycogen and stores it to lower the blood glucose
level.

Describe how insulin controls blood glucose levels in the body

When you eat your blood sugar rises:
1. The pancreas detects the rise in
blood glucose
2. The pancreas secretes insulin
into the blood stream
3. The insulin travels to the liver
4. The liver absorbs the glucose
and converts it into glycogen
5. Blood glucose returns to normal

When you exercise your blood sugar falls:

6. The pancreas detects the fall in blood glucose
7. The pancreas secretes glucagon into the blood stream
8. The glucagon travels to the liver
9. The liver converts glycogen to glucose and releases it into the blood
10. Blood glucose returns to normal

4
Explain the causes of diabetes

Diabetes is a disorder where a person cannot control their blood glucose concentration on their own. It comes is two
forms summarised below:

Type 1 Type 2
Body’s immune system accidently attacking Poor diet and obesity over a long period of
Caused by
pancreas cells time
Liver is unable to recognise insulin in the
Effect Pancreas no longer makes insulin
blood
Consequenc
Blood sugar rises Blood sugar rises
e
Negative Feedback

Define negative feedback

A negative feedback control system responds when conditions change from the optimum and the cycle works to
return conditions to the optimum level. Negative feedback loops are a continuous cycle. They are vital for keeping
optimum levels in the body and therefore maintaining stable conditions (homeostasis). An example of a negative
feedback loop is blood glucose control. An increase in blood glucose level causes the pancreas to secrete more
insulin. Insulin lowers blood sugar levels, this then causes the pancreas to stop secreting insulin. This prevents blood
glucose levels from going too high above the optimum.

The opposite to this would be a positive feedback system where an effector causes an increase, driving levels further
away from the optimum. An example of positive feedback is contractions during childbirth. The hormone oxytocin is
released stimulating the contraction of the uterus. This produces pain. Instead of lowering the oxytocin and causing
the pain to subside, more oxytocin is produced until the contractions are powerful enough to produce childbirth.

Part 2 - Explain why the hormone thyroxine is an example of negative feedback

The thyroid gland is found in your neck and uses iodine from our diet to produce a
hormone called thyroxine. It controls the basal metabolic rate – the rate of respiration
needed to carry out processes to keep you alive.

Normally, the concentration of thyroxine in the blood of adults remains stable. This
happens as a results of a negative feedback loop involving the pituitary gland.

The pituitary gland stimulates the thyroid gland

to release thyroxine, once a certain amount of
thyroxine is present in the blood it stops the
pituitary gland from stimulating the thyroid gland so less thyroxine is
produced.

The pituitary gland can be affected by two conditions which change how it
stimulates the thyroid gland:

Stimulus Body temperature decreases Body experiences stress

Receptors In the pituitary gland In the pituitary gland
Response Pituitary stimulates thyroid gland (the Pituitary stops stimulating thyroid gland (the effector)
effector) so more thyroxine released so less thyroxine is released
Change Increases basal metabolic rate, increased Basal metabolic rate decreases, reduced respiration
respiration generates heat rate causes more nutrients to be stored as fat.

5
 Lesson 1 – Importance of Homeostasis

Key Words

A set of self-regulating stages comprising of:  optimum point, receptor, coordinator, effector and

Control mechanism 
feedback loop 
Homeostasis  The maintenance of a constant internal environment 
Control systems that keep the internal environment within narrow limits, keeping the environment
Homeostatic systems
in a state of dynamic equilibrium
Hormone Chemical messengers usually proteins or steroids
Gland Group of cells that are specialised to secrete a useful substance such as a hormone
Part of the brain next to the pituitary gland; the control center for the ANS eg controls
Hypothalamus 
temperature, water balance 
When the feedback causes the corrective measures to be turned ‘off’, so returns the system to its
Negative feedback 
original or (normal) level 
Osmoregulation  The homeostatic control of the water potential of the blood. 
When the feedback causes the corrective measures to be turned ‘on’, so makes the system deviate
Positive feedback 
even further from its original or (normal) level 
Narrowing the diameter of arterioles near the surface of the skin, so that less blood volume passes
Vasoconstriction 
close to its surface via capillaries, retaining heat 
Widening the diameter of arterioles near the surface of the skin, so that warm blood passes close
Vasodilation 
to its surface via capillaries 

Notes

Homeostasis in mammals is the process of maintaining the internal environment within restricted limits. Multiple
physiological control systems are involved to maintain temperature, pH, glucose concentration and water content
but they are all examples of negative feedback systems:

If a factor in the internal

environment increases or
decreases above or below the
ideal level, changes take place to
restore the original level.

A negative feedback control

system responds when conditions
change from the ideal and returns
conditions to the optimum level.
Negative feedback is a continuous
cycle.

Our body has two main systems which it uses to maintain a constant internal environment:

 Nervous system: This uses action potentials in neurones to transfer electrical signals from the receptors
to the brain and spinal cord (co-ordinators) and then to effectors (these can be muscles or glands).
 Endocrine system: This uses hormones which are released from specialised tissues known as glands and
travel through the blood stream to various effector organs.

Temperature and pH must be maintained to regulate enzyme activity. If body temperature deviates too far from the
optimum of 37°C enzyme activity would decrease (if temperature was too low due to low kinetic energy) or enzymes
would denature (if temperature is too high). If blood pH deviates from the optimum (7.35 to 7.45) then enzymes
would denature due to ionic bonds being disrupted which hold the tertiary structure of the enzyme in place.

6
Temperature Control:
The hypothalamus in the brain contains the thermoregulatory centre, it contains receptors sensitive to the
temperature of the blood. It also receives nervous impulses from thermoreceptors in the skin and then sends
impulses along motor neurones to various effectors:
Too Hot Too Cold
Sweat glands in the skin release more sweat. Skeletal muscles contract rapidly (shivering).
The sweat evaporates, transferring heat These contractions need energy from
energy from the skin to the environment. respiration, and some of this energy is also
released as heat.
Blood vessels dilate - allowing Blood vessels constrict – which
more blood to flow through skin allows less blood to flow through
capillaries, and more heat to be skin capillaries and conserve the
lost core body temperature.
This is called vasoconstriction.
This is called vasodilation.
If we are too hot nerve impulses If we are too cold nerve impulses are
are sent to the hair erector muscles sent to the hair erector muscles in
in the skin which relax. This causes the skin which contract. This raises
the skin hairs to lie flat. the skin hairs and traps a layer of
insulating air next to the skin.
This is called pilorelaxation. This is called piloerection.

Behavioural temperature adaptations:

If animals get too hot or cold they can also change their behaviour
in response to a change in conditions to help regulate their
temperature.
E.g – basking in the sun, cooling off with water, seeking shade,
huddling for warmth, being active or reducing activity.

Some organisms can increase or reduce their surface area to

increase or decrease heat loss through conduction.

7
Blood Glucose Concentration is also controlled through negative feedback:
Glucose is constantly needed in cells to produce ATP and provide energy, and it also contributes to the water
potential of blood and body fluids outside of cells.
Blood plasma is 90-92% water with dissolved solutes including glucose, blood glucose concentration must therefore
be controlled to maintain the water potential of blood. Any deviation in the water potential of blood will affect the
metabolism of cells, as well as causing cells to gain or lose water and so vary in size due to osmosis.

Blood glucose levels are

maintained within the optimum
(4-5g in the blood) by an
endocrine control system which
uses negative feedback. The
hormones insulin and glucagon
as well as glands in the liver and
the pancreas are responsible for
maintaining the feedback loop.

Positive Feedback

The opposite of negative feedback is a positive feedback system where a response increases the stimulus, taking
conditions further away from the optimum. An example of positive feedback is contractions during childbirth. The
hormone oxytocin is released stimulating the contraction of the uterus. This produces pain. Instead of lowering the
oxytocin and causing the pain to subside, more oxytocin is produced until the contractions are powerful enough to
produce childbirth.

You can see how different positive and negative feedback mechanisms are by comparing graphical representations
of their responses. In this example blood clotting and temperature regulation:

8
Recall Questions

1. What is homeostasis?
2. What do homeostatic systems involve?
3. What is a hormone?
4. How are hormones secreted?
5. What is a gland?
6. What is negative feedback?
7. Why do body temperature and blood pH need to be controlled?
8. Describe how an enzyme can become denatured at high temperatures.
9. How can the pH affect the rate of an enzyme-controlled reaction?
10. What does the hypothalamus do?
11. What is vasodilation?
12. What is vasoconstriction?
13. Give a physiological response to an increase in body temperature.
14. Give a physiological response to a decrease in body temperature.
15. Give a behavioural response to an increase in body temperature.
16. Give a behavioural response to a decrease in body temperature.
17. Why does blood glucose concentration need to be controlled?
18. What is positive feedback?
19. Why are positive feedback mechanisms not part of homeostasis?
20. Give an example of a positive feedback mechanism.

Exam Questions

Q1.   The graph shows the effect of increasing the

environmental temperature on the metabolic rate of a
small mammal.

(a)     Suggest one way of measuring the metabolic

rate.

......................................................................................................................

...................................................................................................................... (1)

(b)     The small mammal has ears which are usually pink, but they appear pale when the
environmental temperature is low. Explain the pale appearance of the mammal’s ears when the
environmental temperature is low.

......................................................................................................................

......................................................................................................................

......................................................................................................................

......................................................................................................................

......................................................................................................................

......................................................................................................................

9
 (3)

Q2.  (a)     (i)      What is meant by homeostasis?

.............................................................................................................

............................................................................................................. (1)

(ii)     Giving one example, explain why homeostasis is important in mammals.

.............................................................................................................

.............................................................................................................

.............................................................................................................

............................................................................................................. (2)

(b)     (i)      Cross-channel swimmers experience a large decrease in external temperature when they
enter the water. Describe the processes involved in thermoregulation in response to this
large decrease in external temperature.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________ (6)

(ii)     A person swimming in cold water may not be able to maintain their core body temperature
and begins to suffer from hypothermia. Explain why a tall, thin swimmer is more likely to
suffer from hypothermia than a short, stout swimmer of the same body mass.

.............................................................................................................

.............................................................................................................

.............................................................................................................

.............................................................................................................
(2)

10
 (c)     Cross-channel swimmers may suffer from muscle fatigue during which the contraction
mechanism is disrupted. One factor thought to contribute to muscle fatigue is a decrease in the
availability of calcium ions within muscle fibres. Explain how a decrease in the availability of
calcium ions could disrupt the contraction mechanism in muscles.

......................................................................................................................

......................................................................................................................

......................................................................................................................

......................................................................................................................

......................................................................................................................

...................................................................................................................... (3)

Q3. How does maintaining a constant body temperature allow metabolic reactions in cells to proceed
with maximum efficiency?

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________ (5)

Q4. The human body-louse is an insect which lives and feeds on the surface of the skin. A louse was
placed in a chamber, half of which was kept at 35 °C and half at 30 °C. The diagram shows the pattern of
movement of the louse.

11
 (a)     Name the type of behavioural response shown by the body-louse in this investigation.

Give evidence for your answer.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(2)

(b)     Suggest and explain one advantage of this behaviour to the human body-louse.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(2)

Q5.
The body loses heat quickly in cold water. A researcher investigated the effect of length of time
in a bath of ice-cold water on the reaction times of 20 healthy people aged between 21 and 23
years of age.

She measured each person’s reaction time after being left in ice-cold water for 15, 30 or 45
seconds. She also recorded each person’s reaction time before being placed in the ice-cold
water (0 seconds).

The table shows her results.

 
Length of time in bath of
Mean reaction time / seconds Standard error
ice-cold water / seconds

0 0.395 0.0124

15 0.301 0.0105

30 0.297 0.0212

12
 45 0.326 0.0183

(a)     (i)      One reason that reaction time is slower when body temperature falls is because
nerve impulse conduction is slower. Explain how a lower temperature leads to
slower nerve impulse conduction.

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________ (2)

Homework:

arterioles        blood        blood glucose        cellular        fluctuations        glands        histamines        internal        long-
lasting        negative        osmosis        paracrine        permeability        pH        positive        prostaglandins       
proteins        secreted        target organs        temperature        tissue        water potential

Homeostasis is the maintenance of a constant __________ environment, such as the volume, chemical make-up and

temperature of the ________ and __________ fluid. There are continuous ______________ but they occur around a

set point: homeostasis is the ability to return to that set point thus maintaining equilibrium. There are numerous

reasons why this is important, including:

 Enzymes and other ___________ are sensitive to changes in ___ and _______________. Controlling blood

CO levels and temperature ensures enzymes are able to act at their optimum rate.
2

 ________ ____________ of blood and tissue fluid should be kept constant to ensure cells do not burst or

shrink due to ____________. Maintaining a constant _________ __________ concentration ensures that the

water potential of the blood remains the same.

Homeostasis normally involves ___________ feedback. This occurs when feedback results in the corrective measures

returning a condition to the set point when it increases above or decreases below that value. These include control

of blood glucose, temperature and blood CO levels.  2

Some, few, homeostatic mechanisms involve ___________ feedback. This occurs when a change in conditions results

in a further change away from the set point. Examples include during an action potential, the action of oestrogen on

LH concentration and during hyperthermia.  

Homeostasis can involve either the nervous system or endocrine system. The endocrine system comprises a series of

__________ that secrete chemical messengers (hormones) and the __________ __________that have

13
complementary receptors and so are able to detect and respond to these hormones. Hormones are effective in small

quantities, yet have widespread (since they are carried in the blood) and ______-________ effects.

Nervous and hormonal forms of communication are only useful at coordinating the activities of the whole organism.

At the __________ level they are complimented by local chemical mediators as part of the ____________ system.

These are ____________ by individual cells and affect other cells in the immediate vicinity. A common example of

this type of coordination is the inflammation of certain tissues when they are damaged or exposed to foreign agents.

Lesson 2 – Controlling Blood Glucose Concentration

Key Words

A hormone produced by α cells at the islets of Langerhans in the pancreas that increases
Glucagon
blood glucose levels by initiating the breakdown of glycogen to glucose

Happens in the liver - conversion of non-carbohydrates (e.g. glycerol and amino acids) into

Gluconeogenesis 
glucose; literally ‘glucose-new-manufacture’. Happens when glycogen supply is exhausted. 
Happens in the liver - conversion of glucose into glycogen – literally ‘making glycogen’.
Glycogenesis 
Happens when blood glucose level is higher than normal. 
Happens in the liver - breakdown of glycogen to glucose – literally ‘hydrolysis of glycogen’.
Glycogenolysis 
Happens when blood glucose level is lower than normal. 

Notes
Factors that influence blood glucose concentration
Blood glucose concentration should stay between 4-8mmol dm-3 of
blood. If the concentration is too low cells may not have enough glucose
for respiration and may not function normally – brain cells are especially
sensitive to this. If blood glucose levels are too high, it can disrupt the
water potential of blood and cause disruption as water will start to
move in and out of cells – including red blood cells! In patients with
diabetes a very high or low concentration of glucose can cause death.

Blood glucose concentration increases in the body when:

 Carbohydrates are broken down into monosaccharides in the small intestine and absorbed into the blood
 Glycogen stores in the liver are broken down to release glucose (glycogenolysis).
 When other substances are converted into glucose e.g lactate (lactic acid produce in muscles through
anaerobic respiration), amino acids, glycerol, fatty acids (gluconeogenesis). This also happens in the liver.

Blood glucose concentration decreases in the body when:

 During exercise – increased levels of respiration in muscles reduces blood glucose levels as uptake into
muscles increases.
 If glucose levels are too high the liver removes glucose from the blood and converts it into glycogen
(glycogenesis).
 Drinking alcohol can prevent the liver from producing glucose so can cause a decrease in blood sugar levels.

14
Blood glucose concentration is controlled by an
endocrine system:

Receptors: located in the islets of Langerhans

(endocrine tissue) in the pancreas.

Signals: The hormones insulin and glucagon –

both secreted by the pancreas

Effectors: liver, muscle and fat cells are the target

cells of the hormones, they have specific
receptors on their membrane. They act as
effectors in response to them.

Effect of Insulin:

Endocrine glands are the glands that secrete hormones without ducts, while exocrine glands secrete hormones
through ducts. The pancreas contains both exocrine and endocrine tissue, the exocrine tissue secretes digestive
enzymes into the bile duct. The endocrine tissue (the islets of Langerhans) secretes hormones. The islets of
Langerhans contain two cell types:
 α cells that secrete the hormone glucagon
 β cells that secrete the hormone insulin

Action of Insulin when Blood Glucose Concentration is Too High:

1. β cells detect the increase in blood glucose concentration

2. Glucose moves into β cells by facilitated diffusion
3. Causes insulin-containing vesicles to move towards the cell-surface membrane where they release insulin
into the capillaries
4. Insulin binds to specific receptors on the membranes of target cells (muscle, liver and fat storage cells)
5. Insulin binding stimulates the cells to activate/add more glucose transporter proteins to their cell surface
membrane which increases the permeability of the cells to glucose
6. Rate of facilitated diffusion of glucose into these cells increases, lowering blood glucose concentration.
15
 7. Insulin binding to receptors on
liver cells causes the increase of
uptake of glucose in the liver by
stimulating glycogenesis which
converts glucose to glycogen. This
helps to lower the glucose
concentration in the liver cell
which maintains the glucose
concentration gradient between
the capillaries and the liver cells.

Glucagon works in the opposite way to

insulin. When blood glucose concentration
is low, more glucagon is secreted and less
insulin is secreted but when blood glucose
concentration is high, more insulin is
secreted, and less glucagon is secreted.

Action of Glucagon when Blood Glucose Concentration is Too Low:

1. The decrease in blood glucose concentration is detected by the α and β cells in the islet of Langerhans
2. The β cells respond by stopping the secretion of insulin, this reduces the use of glucose by liver and muscle
cells
3. The α cells respond by secreting glucagon, which binds to receptors in the cell surface membranes of liver
cells
4. Glucagon binding activates enzymes involved in the conversion of glycogen to glucose (glycogenolysis) and
enzymes involved in the conversion of glycerol and amino acids into glucose (gluconeogenesis).
5. Glucose is released from the liver and blood glucose concentrations increases.
Recall Questions

1. What is gluconeogenesis?
2. What is glycogenesis?
3. What is glycogenolysis?
4. What is the endocrine tissue found in the pancreas?
5. What 2 cells make up the islets of Langerhans?
6. What hormone is secreted by the alpha cells of the islets of Langerhans?
7. What hormone is secreted by the beta cells of the islets of Langerhans?
8. What hormone is secreted if blood glucose concentration is above normal?
9. What hormone is secreted if blood glucose concentration is below normal?
10. What is the effect of insulin on blood glucose concentration?
11. What is the effect of glucagon on blood glucose concentration?
12. What are the 2 target cells of insulin?
13. What 4 effects does insulin have on its target cells?
14. How does insulin cause an effect on target cells?
15. What is the target cell for glucagon?
16. What 3 effects does glucagon have on its target cells?
17. Where is Glucagon produced and what does it do?
18. What is meant by describing insulin and glucagon as antagonistic hormones?
19. How is negative feedback involved in the control of blood glucose levels in the blood?

Exam Questions

16
17
(b)

18
Q2. The pancreas produces the hormone insulin.
Put a tick (✔) in the box next to the statement which describes incorrectly the action of
insulin.
 
Activates enzymes involved in the conversion of
glucose to glycogen.

Controls the uptake of glucose by regulating the

inclusion of channel proteins in the surface
membranes of target cells.

Attaches to receptors on the surfaces of target

cells.

Activates enzymes involved in the conversion of

glycerol to glucose.
(1)

Q3. The diagram shows some of the events which maintain blood glucose concentration in a mammal.

(a)     Name

(i)      hormone A; ____________________________________________________

(ii)     organ B. _______________________________________________________

(2)

(b)     Explain why the events shown in the diagram can be described as an example of
negative feedback.

___________________________________________________________________

___________________________________________________________________
(1)
Q4. Explain how insulin lowers the concentration of blood glucose.
___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________ (3)

19
Q5. Homeostatic mechanisms maintain a constant environment in the body.
(a)     The graph shows changes in plasma glucose concentration that occurred in a person who
went without food for some time.

Use evidence from the graph to explain the role of negative feedback in the control of
plasma glucose concentration.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(5)

20
Q6. (a)     Sucrose, maltose and lactose are disaccharides.
(i)      Sucrase is an enzyme. It hydrolyses sucrose during digestion. Name the products of
this reaction.

_________________________ and _________________________ (2)

(ii)     Sucrase does not hydrolyse lactose. Use your knowledge of the way in which
enzymes work to explain why.

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________ (2)

(b)     A woman was given a solution of sucrose to drink. Her blood glucose concentration was
measured over the next 90 minutes. The results are shown on the graph.

(i)      Describe how the woman’s blood glucose concentration changed in the period
shown in the graph.

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________ (2)

(ii)     Explain the results shown on the graph.

______________________________________________________________

______________________________________________________________

______________________________________________________________ (2)

21
Q7. When insulin binds to receptors on liver cells, it leads to the formation of glycogen from glucose.
This lowers the concentration of glucose in liver cells.

Explain how the formation of glycogen in liver cells leads to a lowering of blood glucose
concentration.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________ (2)

Q8. Scientists investigated the control of blood glucose concentration in mice. They kept a group of
normal mice without food for 48 hours. After 48 hours, the blood glucose concentrations of the mice were
the same as at the start of the experiment.

(a)     Explain how the normal mice prevented their blood glucose concentration falling when
they had not eaten for 48 hours.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(3)

The scientists then investigated mice with a mutation that prevents their liver cells making
glucose. They kept a group of these mice without food for 48 hours. After 48 hours, the mean
blood glucose concentrations of the mutant mice and the normal mice were the same.

The scientists investigated how blood glucose concentration is controlled in these mutant mice.
An enzyme required for synthesis of glucose is coded for by a gene called PCK1. The scientists
measured the mean amount of mRNA produced from this gene in cells from the kidneys and
intestines of normal mice and mutant mice. They did this with mice that had previously been
without food for 48 hours. The scientists’ results are shown in the graph.

22
 (b)     Use information from the graph to suggest how blood glucose concentration is controlled
in the mutant mice, compared with the normal mice.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(3)

(c)     The scientists performed statistical tests on the data shown in the graph, to see whether
the differences in the amount of mRNA in cells from normal and mutant mice were
significant. Both the probability values they obtained were p<0.01.

Explain what this means about the differences in the amounts of mRNA produced.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(2)

Homework

Complete the sentences using the words in bold:

90        adenylate cyclase        adrenal        adrenaline        ATP        beta        blood        blood        cAMP        decrease       
diet        endocrine        enzyme        enzymes        exercise        exocrine        glucagon        glucagon       
gluconeogenesis        glycogen        glycogen        glycogenesis        glycogenolysis        hypoglycaemia        increase       
insulin        insulin        IRS        Langerhans        lipids        lipogenesis        muscle        proteins        receptors       
starvation        transporter

Glucose levels in the blood might increase (hyperglycaemia) if gained directly from the diet, from the breakdown of

glycogen (__________________) or from the production of new glucose from sources other than carbohydrates

(__________________). Glucose levels in the blood might decrease (hypoglycaemia) if the body undergoes a period

of ______________, glucose is used up rapidly during ______________ or it is stored as glycogen (______________)

or lipids (______________). The control of blood glucose acts on a negative feedback system as the hormones work

to keep blood glucose at around ____mg per 100ml of blood. 

The pancreas is both an endocrine and exocrine gland:

23
  ___________function -  secretes digestive enzymes into the pancreatic duct .

 ___________ function - secretes hormones (insulin and glucagon) directly into the blood.

Hormones are secreted from the cells in the islets of ______________:

The β cells detect a _____________in blood glucose level and then secrete ______________ into the blood plasma.

Insulin receptors are located on the surface of muscle and liver cells. When insulin is bound to its receptor the

following happens: 

1. The insulin receptor protein acts as an ________________ that activates the second messenger molecule

______. 

2. This causes an increase in the number (and/or activates) glucose ________________ proteins so that there is

an increase in uptake of glucose into the cells.

3. Enzymes that convert glucose to _____________ are also activated. 

4. This results in the removal of glucose from the ____________.

The α cells detect a _____________in blood glucose level and then secrete ____________ into the blood. Glucagon

receptors are primarily located on the surface of liver cells.

Type 1 (insulin dependent) is often due to an autoimmune response where the body attacks _______ cells in the

Islets of Langerhans. The result is that the sufferer cannot produce ____________. This is normally controlled by

insulin injections. Insulin cannot be taken orally since stomach ___________ will break down insulin. The dose of

insulin must match the amount of glucose in the blood to avoid ______________ leading to unconsciousness.

Type 2 (insulin independent) results when ___________ on cells lose their responsiveness to insulin. This is normally

controlled by a controlled _______ and matching this to exercise. 

24
Glucose Tolerance Questions

Glucose tolerance tests are sometimes given to people with suspected type 1 diabetes. The person eats and drinks
nothing except water for 12 hours, and then is given a glucose drink (50g in 200cm 3). Their blood glucose is then
monitored every 30 minutes for a total of 3 hours.

The results from a non-diabetic person and two people with diabetes are shown below:

Results of a glucose tolerance test

Non-diabetic Dibetic 1 Diabetic 2

2.5

2
Blood glucose concentration/mmol dm-3

1.5

0.5

0
0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 2 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 3
Time/Hours

1. The three test subjects took in no carbohydrates for 12 hours before the test, yet their initial blood sugar
concentrations are not the same. Suggest two reasons for this. [2]

2. What precautions would be necessary in the 3 hours of the test to ensure a valid comparison? [2]

3. What is the maximum difference between the blood glucose concentrations in the blood of the non-diabetic
person and diabetic 2 during this test? [1]

4. Suggest two reasons for the difference seen in the responses of the two people with diabetes. [2]

5. What would a diabetic (with type 1 diabetes) normally do to avoid the excessive rise in blood glucose shown
here? [2]

25
 Lesson 3 – Adrenaline and Secondary Messengers

Key Words

Adrenaline A hormone produced by the adrenal glands in times of stress that prepared the body for an emergency

Second
The way a non-lipid-soluble hormone eg glucagon or adrenaline acts on a cell, by triggering production of
messenger
an intermediary ‘second’ messenger eg cyclic AMP by activating adenyl cyclase  
model 

Notes

Some hormones are proteins, although they act as chemical messengers for the endocrine system they have to bind
to receptors on target cells because they are not lipid soluble and cannot just diffuse through the plasma membrane.
This means they have to rely on secondary messengers to work inside the cells and amplify the original signal from
the hormone. Glucagon and Adrenaline are two examples of protein hormones which use this secondary messenger
model.

The activation of glycogenolysis in liver cells occurs as a result of in two ways:

With glycogen:

1. Glucagon binds to liver cell membrane receptors

2. G protein is activated which activates the enzyme adenylyl cyclase by changing its shape
3. Active adenylyl cyclase converts ATP to cyclic AMP (cAMP)
4. cAMP is the second messenger and initiates a protein kinases.
5.  Protein kinase enzymes activate a cascade which catalyses the breakdown of glycogen to glucose
(glycogenolysis).

With adrenaline:

1. Adrenaline is a hormone which binds to

different receptors on liver cells to glucagon
2. This causes the enzyme adenylyl cyclase to
change shape and become activated
3. Active adenylyl cyclase catalyses the conversion
of ATP to the second messenger, cyclic AMP
(cAMP)
4. cAMP is the second messenger and initiates a
protein kinases.
5. Protein kinase enzymes activate a cascade
which catalyses the breakdown of glycogen to
glucose (glycogenolysis).

Other Actions of Adrenaline to Increase Blood Glucose

 Adrenaline is released from adrenal glands

 It is secreted when there is a low concentration of blood glucose but also when you are stressed or
exercising
 Adrenaline activates glycogenolysis (as above) but also inhibits glycogenesis (glucose -> glycogen)
 It also activates glucagon secretion and inhibits insulin secretion from the pancreas to make sure glucose
concentration in the blood increases.
 Adrenaline also stimulates the breakdown of glycogen stores in muscles during exercise
 The glucose produced remains in the muscle cells where it is needed for respiration
 Adrenaline is preparing the body for flight or fight response by making more glucose available to muscles for
respiration.

26
Recall Questions

1. Why can’t protein hormones pass through the cell membrane?

2. What is a first messenger?
3. What is a second messenger?
4. Name an example of a second messenger.
5. What hormone is secreted from the adrenal medulla?
6. What is Adrenaline?
7. Name four target cells of adrenaline and what effect it has on each.
8. What is the second messenger for glucagon?
9. What happens next once adrenaline binds to the receptor on the cell surface?
10. What is the role of cAMP in the action of adrenaline on a cell?
11. What effects are caused on the cell by having more cAMP?
12. What is glycogenolysis and what can activate it?

Exam Questions

Q1. Adrenaline binds to receptors in the plasma membranes of liver cells. Explain how this
causes the blood glucose concentration to increase.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(2)

Q2. Explain how inhibiting adenylate cyclase may help to lower the blood glucose
concentration.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(3)

27
3.

6.

28
4.

Homework

When glucagon is bound to its receptor the following happens: 

1. The enzyme _______________ ______________ is activated that converts ________ to _________. 

2. This second messenger stimulates the conversion of _____________to glucose. 

29
 3. There may also be an increase in the conversion of ______________ and ______________into glucose.

There are a number of other hormones that increase blood sugar levels. The most well-known is _______________.

This is produced in the ______________ glands (located above the kidneys). Adrenaline only acts on _____________

cells and stimulates the same response as ______________.

1. Number the statements to make a flow chart to summarise how glucagon can cause the conversion of

glycogen to glucose: [4]

o An enzyme inside the cell surface membrane is activated

o Glucagon binds to its receptor in cell surface membrane

o cAMP (cyclic AMP) activates enzymes that catalyse the breakdown of glycogen to glucose 

o The enzyme converts ATP to cAMP (cyclic Adenosine Mono Phosphate)

2. Name the 1 messenger molecule in this system. [1] ……………………………………………………………………….

st

3. What other hormone could also act as the 1 messenger?[1] …………………………………………………………

st

4. Name the 2 messenger in this system. [1] ……………………………………………………………………………………..

nd

5. What is the advantage of using a 2 messenger? [1] ……………………………………………………………………….

nd

………………………………………………………………………………………………………………………………………………………….

6. What is the name of the enzyme mentioned in the flow chart? [1] ………………………………………………….

Lesson 4 – Kidney Structure

Key Words

A tiny vessel that ultimately arises from the renal artery and supplies the nephron with blood. The
Afferent arteriole 
afferent arteriole enters the renal capsule of the nephron where it forms the glomerulus. 
Blood capillaries  A concentrated network of capillaries that surround the proximal convoluted tubule, the loop of

30
 Henle and the distal convoluted tubule and from where they reabsorb mineral salts, glucose and
water. They merge together into venules and then into the renal vein. 
A tube into which a number of distal convoluted tubules from a number of nephrons empty. It is
Collecting duct  lined by epithelial cells and becomes increasingly wide as it empties into the pelvis of the kidney. It
is permeable to water and so as the filtrate moves down it the water passes out of it by osmosis. 
A lighter coloured outer region made up of renal (Bowman’s) capsules, convoluted tubules and
Cortex 
blood vessels 
A series of loops surrounded by blood capillaries. Its walls are made of epithelial cells, but it is
Distal convoluted surrounded by fewer than the proximal tubule. It makes final adjustments to the water and salts
tubule  that are reabsorbed and to control the pH of the blood by selecting which ions to reabsorb. The
permeability of its walls are altered under the influence of various hormones. 
A tiny vessel that leaves the renal capsule. It has a smaller diameter than the afferent arteriole and
Efferent arteriole  so causes an increase in blood pressure within the glomerulus. It carries blood away from the renal
capsule and later branches into the blood capillaries. 
A many-branched knot of capillaries from which fluid is forced out of the blood. They recombine to
Glomerulus 
form the efferent arteriole.  
A long, hairpin loop that extends from the cortex into the medulla of the kidney and back again
Loop of Henle 
which is surrounded by blood capillaries. 
Medulla  A darker coloured inner region made up of loops of Henle, collecting ducts and blood vessels 
Nephron  The functional unit of the kidney – there are about one million tubular structures in each kidney.  
Proximal convoluted A series of loops surrounded by blood capillaries which are adapted to reabsorb substance into the
tubule  blood by having walls made of epithelial cells which have microvilli. 
The closed end at the start of the nephron. It is cup-shaped and surrounds a mass of blood
Renal (Bowman’s)
capillaries known as the glomerulus. The inner layer of the renal capsule is made up of specialized
capsule 
cells called podocytes. 
Renal artery  Supplies the kidney with blood from the heart via the aorta 
Renal pelvis  A funnel-shaped cavity that collects urine into the ureter 
Selective Reabsorption The uptake of some substances from the kidney tubule into the blood
Ureter  A tube that carries urine to the bladder 

Notes

The kidneys form the urinary system with the bladder and have
two roles in the body:

 Osmoregulation – maintaining the water potential of

blood by removing excess water or retaining water.
 Excretion – removing nitrogenous waste (excess protein)
in the form of urea from the blood.

There are two kidneys, each receives blood from the renal artery.
Kidneys act like filters, removing urea from the blood and diluting
it with water to form urine. Urine is then sent to the bladder for
storage via the ureter. Once the bladder fills the urine passes out
through the urethra.

The kidney reabsorbs important amino acids, salts and glucose

that it filters out of the blood initially so that they are not lost in
urine. The amount of water in the urine is adjusted to maintain
the water potential of the blood.

Kidney Structure

Nephron – fine tube structures which carry out filtration and reabsorption. There are roughly one million nephrons
in each kidney (200,000 – 2.5 million).

The Cortex – the outer layer jammed pack full of the filtration parts of the nephrons. Filters the blood.

31
Medulla – the inner layer which contains the tubes carrying filtered wastes to the centre (pelvis) of the kidney.
Contains the loop of Henle and the collecting duct parts of the nephrons.

Renal Pelvis – Where all the collecting ducts come together and connect to the ureter.

Ureter – transports urine to the bladder to be excreted.

Ultrafiltration

The first function of the nephron is to filter the blood. This takes place at a structure called the glomerulus: A many-
branched knot of capillaries from which fluid is forced out of the blood using blood pressure .

Blood enters the glomerulus from the renal artery

through the afferent arteriole, the blood flows through
the knot of capillaries and leaves through the efferent
arteriole which has a narrower lumen than the afferent
arteriole. This creates a high hydrostatic pressure which
forces plasma from the blood through the walls of the
capillaries into a filter called the Bowman’s capsule.

Small molecules can leave including glucose, amino acids,

hormones, urea, water, and ions but large proteins and
red blood cells are too big to pass through the gaps in the
walls of the capillary endothelium called fenestrations.

The plasma then passes through a filter into the lumen of the Bowman’s
capsule which is a cup shaped sack around the glomerulus. The filter is
made up of the basement membrane and specialised Bowman’s capsule
epithelial cells called podocytes. The foot processes known as pedicels
that extend from the podocytes wrap themselves around the capillaries
of the glomerulus to form filtration slits. The pedicels increase the surface area of the cells enabling efficient
ultrafiltration. Podocytes also secrete and maintain the basement membrane which is a mesh like layer of proteins.
This filtration system prevents large or charged molecules from entering the glomerular filtrate which then flows
through the rest of the nephron.

32
Selective Reabsorption

The rest of the nephron is responsible for making sure necessary, useful molecules remain in the body, firstly this is
done through selective reabsorption then through the reabsorption of water. The glomerular filtrate flows from the
Bowman’s capsule into the proximal convoluted tubule (PCT) where approximately 85% of the filtrate is reabsorbed
into the blood including:

 All of the glucose – needed for respiration

 All of the amino acids – needed for building proteins
 Some inorganic salts – often ones low in concentration in the blood, not high in diet
 Most of the water moves back into the blood by osmosis

The cells lining the PCT are specialised to maximise reabsorption:

• Folded membrane to give large surface area so lots of reabsorption can occur simultaneously
• Lots of membrane proteins for facilitated diffusion of glucose and amino acids via co-transport with sodium
• Lots of ribosomes to make those membrane proteins
• Lots of mitochondria to provide the ATP for protein synthesis and active transport which could be used to
reabsorb the molecules

Recall Questions

1. What are the two key functions of the kidneys?

2. What are the 3 vessels associated with the kidney?
3. What are the 3 regions of the kidney (from outside to inside)?

33
 4. What are the kidney tubules called?
5. What are the 5 components of the nephron?
6. What is the name for the knot of capillaries surrounded by the Bowman's capsule?
7. What arteriole enters the glomerulus?
8. What arteriole exits the glomerulus?
9. What is the difference in the structure of the afferent and efferent arterioles?
10. What is Ultrafiltration
11. What structures of the kidneys are involved in ultrafiltration?
12. What are the 3 layers through which ultrafiltration occurs?
13. What 5 substances are able to pass from the glomerulus into the Bowman's capsule?
14. What 2 substances are unable to pass from the glomerulus into the Bowman's capsule?
15. What is selective reabsorption
16. Where does selective reabsorption mainly take place in the nephron?
17. What is the importance of selective reabsorption?
18. How are epithelial cells lining the PCT adapted for their role?
19. What 4 substances are reabsorbed in the proximal convoluted tubule?
20. What are the 4 specialisations of the PCT epithelial cells?
21. What cotransport occurs in the PCT?

Exam Questions

Q1. In a mammal, urea is removed from the blood by the kidneys and concentrated in the filtrate.
(a)     Describe how urea is removed from the blood.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(2)

Q2. In the kidney, ultrafiltration and selective reabsorption are two of the processes involved in the
formation of urine.

(a)     (i)      Where does ultrafiltration occur?

______________________________________________________________
(1)

(ii)     Give one component of the blood which is not normally present in the filtrate.

______________________________________________________________
(1)

b)     The kidneys remove a substance called creatinine from the blood. The rate of creatinine
removal is a measure of the rate of filtration of the blood.

In one hour, a person excreted 75 mg of creatinine in his urine. The concentration of

34
 creatinine in the blood entering his kidneys was constant at 0.01 mg cm−3.

Calculate the rate at which the blood was filtered in cm3 min−1. Show your working.

Filtration rate = ____________________ cm3 min−1

(2)

(c)     Reabsorption of glucose takes place in the proximal tubule. Explain how the cells of the
proximal tubule are adapted for this function.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(2)
Q3.

Q4. Three processes are involved in the formation of urine in a mammalian kidney. These are
ultrafiltration, selective reabsorption and concentration. The diagram shows where these processes take
place in a nephron.
35
  

(a)     Describe how ultrafiltration produces glomerular filtrate.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(5)

Q5. Glomerulosclerosis is a disease in which the glomeruli of the kidney are damaged.
Explain why protein is not normally present in the urine of a healthy person but may be present in the
urine of a person with glomerulosclerosis.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(2)

36
Q6

37
Homework

Complete the sentences using the words in bold:

ascending        arterioles        blood        Bowman’s        cortex        cortex        descending        distal        diameter       

endothelial        epithelial        excreting        fall        filtering        filtrate        glucose        Henle        hypothalamus       
ion        less        low        medulla        microvilli        more        nephrons        osmoreceptors        osmosis        osmotic       
pituitary        pressure        proteins        proteins        proximal        reabsorbing        renal        rise        sodium       
ultrafiltration        urea        urine        water

Structure and function of the kidney

The kidney is responsible for ___________ waste products (such as urea) from the body, as well as controlling blood

water and ______ concentrations. These processes prevent the body from becoming dehydrated or overhydrated,

which could lead to __________ damage to cells. ________ is a semi toxic product of the breakdown of

___________, so reval is essential to prevent damage to cells. The kidney achieves these processes by

_____________ much of the plasma from the blood and then selectively ____________ substances the body needs.

It is made up of two distinct regions: the ___________ (the centre of the kidney) and the __________ (the outer

periphery). Within these regions are different sections of tubules and capillaries, known as ____________.

Blood enters the kidney through the ________ artery which branches into afferent ___________ and then into

bundles of capillaries, known as a glomerulus. Each glomerulus is surrounded by a cup-shaped structure, known as

the ____________ capsule. Blood leaves the glomerulus in the efferent arteriole, which feed into the renal vein.

Since the efferent arteriole has a smaller ____________ than the afferent arteriole, the blood in the glomerulus is

under very high ___________. This causes any water and small molecules (glomerular ___________) in the blood

plasma to be forced out of the capillaries in a process known as _______________. The filtrate first passes through

pores between the ______________ cells of the capillary, then across a basement membrane and finally passes into

the Bowman’s capsule through pores between the _____________ cells and into the tubule of the Bowman’s

capsule. Blood cells, platelets and ___________ are too large to pass out by ultrafiltration and so remain in the

capillary. All of these structures are present in the kidney __________.

From the Bowman’s capsule the filtrate passes through the regions named below where different substances are

selectively reabsorbed back into the blood.

38
 Lesson 5 – Osmoregulation and ADH

Key Words

If a decrease in water potential is detected, more of this hormone is produced by the pituitary gland and
ADH (antidiuretic
it makes the walls of the distal convoluted tubule and collecting duct more permeable to water, meaning
hormone) 
less water leaves the body and urine is more concentrated.  
Channel proteins that form pores in the membrane of biological cells, mainly facilitating transport of
Aquaporin
water between cells.
Ascending limb of Wider, with thick walls that are impermeable to water. Sodium ions are actively transported out of this
loop of Henle  limb which creates a lower water potential in the region of the medulla between the two limbs.  
When two liquids flow in opposite directions past one another, the exchange of substance between
them is greater than if they flow in the same direction next to each other. The counter-current flow
Counter-current
means that the filtrate in the collecting duct with a lower water potential meets interstitial fluid that has
multiplier 
an even lower water potential, meaning the water potential gradient exists for the whole length of the
collecting duct. 
Descending limb Narrow, with thin walls that are highly permeable to water. The filtrate progressively loses water by
of loop of Henle  osmosis at it moves down this limb.  
Osmoreceptors  Cells in the hypothalamus of the brain detect a change in water potential  
Osmoregulation  The homeostatic control of the water potential of the blood. 
Process by which all of the glucose and most other valuable molecules are reabsorbed as well as water in
the proximal convoluted tubule. Sodium ions are actively transported out of cells lining the convoluted
tubule into blood capillaries which carry them away. This causes sodium ions to move by facilitated
Reabsorption of
diffusion down a concentration gradient from the lumen of the proximal convoluted tubule into the
water 
epithelial lining cells. It moves through via co-transport through carrier proteins, each of which carries
another molecules (glucose, amino acids or chloride ions) along with the sodium ions. The molecules
that have moved via co-transport then diffuse into the blood. 
Filtration assisted by blood pressure - process by which glomerular filtrate is formed due to the afferent
arteriole having a larger diameter than the efferent arteriole which causes a build up of hydrostatic
Ultrafiltration  pressure causing water, glucose, urea and mineral ions to be squeezed out of the capillary into the renal
(Bowman’s) capsule. Blood cells and proteins cannot pass across into the renal capsule as they are too
large.  

Notes

Filtration is one role of the kidneys, the other is osmoregulation or control of water potential of the blood. In order
to do this the kidneys have to control how much water is reabsorbed into the blood and how much is removed in
urine.

Loop of Henle

The loop of Henle is where this process starts, its function is

to create a low water potential in the medulla of the kidney.

So far the glomerulus and PCT have been situated in the

cortex of the kidney but the loop of Henle consists of a
descending limb into the medulla and an ascending limb back
out to the cortex. T

his allows salts (sodium and chloride ions) to be transferred

from the ascending limb to the descending limb. The overall
effect is to increase the concentration of salts in the filtrate
so that they diffuse out from the ascending limb into the
surrounding medulla tissue, giving a low (very negative)
water potential.

Remember – the nephron is surrounded by a network of capillaries, water is therefore reabsorbed into the blood not
just out into the tissue fluid.

39
 1 – As fluid is moving up the ascending limb sodium and other ions are actively transported out of the filtrate into
the tissue fluid. The loss of these ions causes the filtrate to become less concentrated (higher water potential)

2 – The sodium ions lower the water potential of the surrounding medulla tissue; the water potential of the medulla
becomes more negative towards the base of the loop of Henle. Water does not follow the ions due to osmosis
because the membrane of the ascending limb is impermeable to water.

3 – The descending limb is permeable to water, so water moves out of the filtrate here by osmosis into blood
capillaries because the ions have made the surrounding tissue have a very low water potential. This concentrates the
filtrate lowering the water potential.

The loop of Henle uses a hairpin countercurrent multiplier because it allows the concentration of the filtrate to
increase (by reabsorbing water) and the concentration of the external tissue to increase (which helps to remove the
water) at the same time. This ultimately allows the nephron to reabsorb more water and concentrate the urine while
at the same time using as little energy as possible.

DCT and Collecting Duct

Filtrate moving from the top of the ascending limb of the loop of Henle into the
distal convoluted tubule and the collecting duct still has a high water potential.
The collecting duct is the last chance for the body to keep hold of any water
that’s been filtered out of the blood. The water potential gradient set up by the
loop of Henle allows water to be absorbed along the whole length of the
collecting duct

The permeability of the membrane of both of these sections of the nephron is

controlled by the hormone ADH (antidiuretic hormone). Any change in blood
water potential is detected by osmoreceptors in the hypothalamus. If the
hypothalamus detects that blood water potential is too low it stimulates the
posterior pituitary gland to secrete more ADH.
40
 Too little water in blood
(low water potential) Too much water in blood
(high water potential)

Low concentration of water in the blood is detected by High concentration of water in the blood is detected by
osmoreceptors in the hypothalamus osmoreceptors in the hypothalamus
Pituitary gland is stimulated to release more ADH Pituitary gland is stimulated to release less ADH
ADH travels in the blood to the kidney ADH travels in the blood to the kidney
ADH causes the collecting ducts to become more ADH causes the collecting ducts to become less
permeable to water permeable to water
This means more water is reabsorbed back into the This means less water is reabsorbed back into the
blood blood
Volume of urine decreases, and concentration Volume of urine increases, and concentration
increases decreases

How ADH works

Cells in the wall of the collecting duct

have receptors for ADH on their
plasma membrane, they also contain
vesicles with aquaporins (water
protein channels).

ADH binds to these receptors and

causes a chain of enzyme controlled
reactions inside the cell using the
secondary messenger model. The
cascade causes the vesicles
containing the aquaporins to move
and fuse with the membrane. This
makes the membrane of cells lining
the collecting duct more permeable
to water.

More ADH in the blood means more aquaporins are inserted allowing more water to be reabsorbed, and less, more
concentrated urine with a lower (more negative) water potential

Summary

41
Recall Questions

1. What is osmoregulation?
2. What is the role of the Loop of Henle?
3. What are the 2 sections of the loop of Henle called?
4. What substance(s) enter the descending limb of the loop of Henle?
5. What substance(s) leave the descending limb of the loop of Henle?
6. What substance(s) leave the ascending limb of the loop of Henle?
7. What happens to the water potential of the urine in the descending limb of the loop of Henle?
8. What happens to the water potential of the urine in the ascending limb of the loop of Henle?
9. What happens to the water potential of the tissue fluid of the medulla towards the bottom of the loop of
Henle?
10. What is the hairpin countercurrent multiplier effect in the loop of Henle?
11. What is the importance of ATP in the loop of Henle?
12. What occurs in the distal convoluted tubule?
13. What happens in the collecting duct?
14. Where is ADH produced?
15. Where is ADH released?
16. What receptors detect changes in the water potential of the blood?
17. Where are osmoreceptors found?
18. What is the role of ADH?
19. How does the body lose water?
20. What are the target cells of ADH?
21. What is the effect of ADH on its target cells?
22. What is an aquaporin?
23. Where are aquaporins found in cells lining the collecting duct that have not been affected by ADH?
24. Where are aquaporins found in cells lining the collecting duct that have been affected by ADH?
25. If water needs to be conserved, __________ ADH is secreted, __________ water is reabsorbed and
__________ urine is produced.
26. If water does not need to be conserved, __________ ADH is secreted, __________ water is reabsorbed and
__________ urine is produced.

Exam Questions

Q1. Humans can produce urine which is more concentrated than their blood plasma.
(a)      Explain the role of the loop of Henle in the absorption of water from the filtrate.

______________________________________________________________

42
 ______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________
(6)

(b)     Explain how urea is concentrated in the filtrate.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(3)

Q2.The kidney plays an important part in the regulation of blood water potential. This involves control of
the amount of water reabsorbed from the filtrate produced in the kidney tubules. The amount of water
reabsorbed affects the volume of urine produced, the rate at which the bladder fills and how often it has
to be emptied.

(a)     Explain how the loop of Henle maintains the gradient of ions which allows water to be
reabsorbed from filtrate in the collecting duct.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(5)

(b)     Explain how ADH is involved in the control of the volume of urine produced.

43
 ___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________ (4)

Q3.  Some desert mammals have long loops of Henle and secrete large amounts of antidiuretic
hormone (ADH). Explain how these two features are adaptations to living in desert conditions.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(6)
Q4. (a)     The control of water balance in the body involves negative feedback.
(i)      Describe what is meant by negative feedback.

______________________________________________________________

______________________________________________________________

______________________________________________________________
(1)

(ii)     Water is removed from the body via the kidneys. Give two other ways in which
water is removed from the body.

1. ____________________________________________________________

2. ____________________________________________________________
44
 (2)

(iii)    Name the part of the brain which acts as the coordinator in the control of water
balance.

______________________________________________________________
(1)

(b)     Figure 1 shows the cells lining the collecting duct in a human kidney. ADH molecules bind to
the receptor proteins and this triggers the vesicles containing aquaporins to bind with the plasma
membrane next to the lumen. Figure 2 shows an aquaporin which is a large channel protein.

Figure 2

(i)      From which gland is ADH released?

______________________________________________________________
(1)

(ii)     Use the information given to explain how ADH increases the movement of water
from the lumen of the collecting duct into the blood.

45
 ______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________
(4)

Q5. Anti-diuretic hormone (ADH) is released into the blood in response to a shortage of water in the
body. ADH enters the collecting duct cells in nephrons and causes the increased synthesis of one type of
protein molecule. These protein molecules are inserted into the plasma membranes of the collecting duct
cells where they act as channels. Only water molecules can pass through these channels, increasing the
reabsorption of water from the kidney filtrate.

(a)     Name the gland which releases ADH.

___________________________________________________________________
(1)

(b)     (i)      Explain how the structure of protein molecules allows them to form channels
through which only water molecules can pass.

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________
(2)

(ii)     Explain how the cells of the collecting duct are able to absorb water from the filtrate
through the protein channels in their plasma membranes.

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________
(2)

Q6. The table shows the concentrations of dissolved substances in different regions of a nephron in a
kidney in the presence and in the absence of antidiuretic hormone (ADH).
 
Region of nephron Concentration of dissolved
substances / arbitrary units
46
 ADH present ADH absent

First convoluted tubule 300 300

Bend of loop of Henle 1000 1000

Start of second convoluted tubule 150 150

Middle of second convoluted tubule 250 90

Start of collecting duct 300 50

End of collecting duct 1000 50

(i)      Describe and explain the effect of ADH on the volume and concentration of urine
produced by the kidney. Give evidence from the table to support your answer.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________ (3)

(ii)     Explain the role of ADH in the production of concentrated urine.

______________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________ (4)

47
Q7. A species of crayfish lives in fresh water.
This crayfish does not have kidneys but it does have an organ
which excretes nitrogenous waste and controls the amount of water
in its body. The diagram shows this excretory organ.

(i)      Describe how excretion in this organ differs from excretion

in a human nephron.

________________________________________

______________________________________

______________________________________

______________________________________

______________________________________

______________________________________

________________________________________
(3)

(ii)     Suggest how the production of large amounts of

dilute urine enables the crayfish to survive in fresh water.

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________
(2)
Homework

Complete the sentences using the words in bold:

ascending        arterioles        blood        Bowman’s        cortex        cortex        descending        distal        diameter       

endothelial        epithelial        excreting        fall        filtering        filtrate        glucose        Henle        hypothalamus       
ion        less        low        medulla        microvilli        more        nephrons        osmoreceptors        osmosis        osmotic       
pituitary        pressure        proteins        proteins        proximal        reabsorbing        renal        rise        sodium       
ultrafiltration        urea        urine        water

1. ___________ convoluted tubule (PCT): _________ is absorbed first by facilitated diffusion and then by active

transport. Water is also reabsorbed by osmosis. The PCT has ____________ to increase the surface area over

which this can occur.

2. Loop of _________: Located in the medulla and made up of two limbs, the _____________ limb (occurs first)

and the _____________ limb (occurs after). __________ ions diffuse out of the bottom of the ascending limb

48
 and are pumped out of top of the ascending limb by active transport. This creates a lower water potential in

the medulla, causing ________ to move out of the descending limb by __________.

3. _________ convoluted tube: The _______ water potential in the medulla also causes water to move out of

the distal convoluted tubule by osmosis.

4. Collecting duct: Water is reabsorbed according to the hydration state of the body. This process is detailed

below.

Any water and molecules that have not been reabsorbed then pass into the ureter that leads to the bladder where it

collects as urine. No ________ is reabsorbed so it is all removed from the body.

Control of blood water potential

Water is lost from the body through sweat, in breath and in _________; activities such as exercising cause more

water to be lost than normal, causing a greater than normal _______ in blood water potential. Water is gained by

drinking, eating and through respiration; taking in water causes a ________ in blood water potential.

Water reabsorption in the collecting duct is a carefully controlled process. _______________ in the

_______________ in the brain monitor blood water potential. If the water potential of the blood decreases (i.e. the

amount of water in the blood plasma decreases) then water moves out of the osmoreceptors. This causes a signal to

be sent to the posterior ___________ gland which in turn releases antidiuretic hormone (ADH). ADH travels through

the __________ and causes the walls of the collecting duct to become _________ permeable to water, allowing

more water to be reabsorbed, so the urine is more concentrated and less water is lost from the body. If the blood

water potential increases too high then ________ ADH is released, less water is reabsorbed, so the urine is more

dilute and more water is lost from the body. 

49
 Lesson 6 – Diabetes

Key Words

Diabetes mellitus A condition where blood glucose concentration cannot be controlled properly.

Insulin dependent, due to body being unable to produce insulin. It normally begins in childhood due to
Type 1 diabetes  an autoimmune response whereby the body’s immune system attacks the β cells of the islets of
Langerhans. 
Insulin independent- due to glycoprotein receptors on body cells losing responsiveness to insulin (or it
Type 2 diabetes  could also be due to inadequate supply from the pancreas). Usually develops in people over the age of
40 years. 

Notes

Summary of blood glucose control

Process Converts Activated by Inhibited by Happens in

Glycogenesis Glucose to Insulin from pancreas Adrenaline from Liver
glycogen adrenal gland
Glycogenolysis Glycogen to Glucagon from pancreas Liver and Muscles
glucose and Adrenaline from
adrenal glands
Gluconeogenesi Glycerol/amino Glucagon Liver
s acids to glucose

Summary of Ultrafiltration and Selective Reabsorption

50
Diabetes mellitus

Diabetes is a condition where blood

glucose concentration cannot be
controlled properly. After eating
blood glucose concentration does not
reduce as it should as glucose is not
being absorbed. A normal blood
glucose concentration of above
7.8mM is considered high enough to
be diabetes.

There are two types:

Type 1 Type 2
β cells in the islets of Langerhans do not produce
The immune system attacks β cells in the enough insulin or the body’s cells do not respond
islets of Langerhans. Not sure why this properly to insulin. This can be caused by fat around
Caused by
happens could be genetic cause or the the organs. Effects people with poor diet, lack of
result of a viral infection exercise but also older people or people with family
history are at risk
Insulin receptors on target cells do not work
Effect Pancreas no longer secretes insulin
properly so cells do not take up enough glucose.
After eating blood sugar levels can become
Consequenc very high – hyperglycaemia. The kidneys Blood glucose concentration is generally higher than
e cannot reabsorb all the glucose. Could lead normal.
to coma and death if it gets too high!
 glucose in urine  urinating more than usual, particularly at night
 increased thirst and a dry mouth  feeling thirsty all the time
Symptoms  needing to urinate frequently  feeling very tired
 tiredness  losing weight without trying to
 unintentional weight loss  cuts or wounds taking longer to heal
Treatment Insulin therapy – injecting insulin regularly Eating a balanced diet and exercise regime. Glucose-
throughout the day after eating. It needs lowering medication can be taken if these do not
to be carefully controlled as injecting too help control it.
much could cause a dangerous drop in Taking insulin or having a pancreas transplant would
blood glucose – hypoglycaemia. Regular, not be effective as cells do not respond properly to
healthy diet helps to control levels. Long insulin.

51
 term stem cell treatment or a pancreas
transplant

Type 2 Diabetes Causes and Responses

Type II diabetes prevalence is increasing in the UK population as it

is linked to increasing levels of obesity. This is a direct result of an
increase in unhealthy diets along with a reduction in physical
activity. Type II diabetes can cause other health problems including
increased risk of heart disease, stroke, vision loss and kidney
failure. This puts a strain on the NHS so health advisors want to try
and increase awareness and reduce obesity levels through
education, but some people believe that the food industry also has
a role to play.

Health Advisors Responses Food Industry Responses

Recommend that people’s diet is low in fat, sugar, Make products healthier by using sugar alternatives to
and salt but contains lots of grains, fruit, and sweeten food and drink and reducing sugar, fat, and salt
vegetables. And promote regular exercise. content. However, there is some evidence to suggest that
artificial sweeteners are linked to weight gain.
Campaigns including the NHS ‘Change4Life’ to There is pressure to increase profits so they are reluctant to
educate people about how having a healthy spend money on developing healthier alternatives if they
lifestyle can reduce their risk of developing will be less popular and make less money.
conditions including Type II diabetes.
Challenging the food industry to reduce advertising The food industry will only change in the long term if public
of junk food to children and make labelling clearer opinion and habits towards healthy eating change.
so that people can make healthier choices.
Testing for glucose in urine

If it is suspected that a person has diabetes a doctor may request a sample of their urine be tested for glucose.
Normally the concentration of glucose in urine should be very low (0-0.8mM). Along with other symptoms if the
value is higher than this could mean the patient has diabetes – a blood test would then be used to confirm this as it
could also be caused by high blood pressure or kidney failure. We can test urine for the presence of glucose using
Benedict’s reagent.

There are two types of Benedict’s reagent:

Quantitative Contains Produces a range of coloured precipitates when boiled from green to brick red
potassium in the presence of reducing sugar.
thiocyanate
Qualitative Contains copper Does not give a red precipitate on boiling. The amount of reducing sugar
sulphate present is measured by the disappearance of the blue colour of copper
sulphate.
Quantitative Benedict’s reagent can be used to test a range
of known concentrations of glucose and a colorimeter used
to measure the absorbance of each sample. This is used to
create a calibration curve (straight lines are still curves!)

The higher the glucose concentration the paler the solution

so the lower the absorbance reading.

Once this has been done, samples of unknown glucose

concentration can be tested with Benedict’s and the

52
absorbance measured. The calibration curve can then be used to estimate the concentration of glucose in the
unknown sample based on its absorbance reading.

Method:

You need to start by making a serial dilution of glucose solution to create a range of concentrations:

1. Fill a test tube with 10 cm3 of the 2M glucose solution

2. Fill 5 test tubes with 5 cm3 of distilled water.
3. Using a pipette transfer 5 cm3 of the glucose solution from
the test tube to the first tube of 5 cm3 of water.
4. Mix the solution thoroughly. You now have 10 cm3 of
glucose solution that is half as concentrated as the solution
in the stock solution (1M).
This make sense as the dilution factor is 5ml/10ml = 1/2 or
1:2 dilution
5. Repeat the process by transferring 5 cm3 from the 1M
solution and adding it to the next tube containing distilled
water to make a 10 cm3 solution which is now half as
concentrated again (0.5M)
6. Repeat to create 0.25M and 0.125M solutions. Add a test tube of pure water at the end as a control.

Now you can test all the concentrations and water using quantitative Benedict’s reagent (QBS):

7. Add the same volume of QBS to the glucose solution in each test tube and stir to mix.
8. Stand the test tube in boiling water for 5 minutes
9. Allow the tubes to stand and cool down.
10. Measure the absorbance of the solution in each tube using a colorimeter set with a red filter (635nm).

Recall Questions

1. What is the cause of type 1 diabetes?

2. What condition is caused by a long period below the normal blood glucose concentration?
3. What is the cause of type 2 diabetes?
4. What is a risk factor for type 2 diabetes?
5. What are the possible treatments for type 1 diabetes?
6. What is the main treatment for type 2 diabetes?
7. Why would a transplant not be an appropriate treatment for type 2 diabetes?
8. If a urine sample contains glucose, what may be a possible diagnosis about the patient?
9. Above what blood glucose concentration is considered a diagnosis for diabetes mellitus?
10. Explain why people suffering from diabetes might need to urinate more often.
11. Explain why people suffering from diabetes may not be able to gain weight.
12. Explain why people suffering from diabetes may feel tired.

Exam Questions

Q1 (a)     A diabetic person and a non-diabetic person each ate the same amount of glucose. One hour
later, the glucose concentration in the blood of the diabetic person was higher than that of the non-diabetic
person. Explain why.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

53
 ___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(3)

(b)     (i)     The urine of a non-diabetic person does not contain glucose. Explain why.

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________
(2)

(ii)     A high blood glucose concentration could cause glucose to be present in the urine
of a diabetic person. Suggest how.

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________
(2)

(c)     A test for glucose in urine uses immobilised enzymes on a plastic test strip. One of these
enzymes is glucose oxidase. Explain why the test strip detects glucose and no other
substance.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________ (2)

(d)     If the glomerular filtrate of a diabetic person contains a high concentration of glucose, he
produces a larger volume of urine. Explain why.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________(3)

Q3. Some people who have diabetes do not secrete insulin. Explain how a lack of insulin
affects reabsorption of glucose in the kidneys of a person who does not secrete insulin.

54
 ___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________ (4)

Q2. Each year, a few people with type I diabetes are given a pancreas transplant. Pancreas transplants
are not used to treat people with type II diabetes.

Give two reasons why pancreas transplants are not used for the treatment of type II
diabetes.

1. _________________________________________________________________

___________________________________________________________________

___________________________________________________________________

2. _________________________________________________________________

___________________________________________________________________

___________________________________________________________________(2)

Q3.
(a)     When insulin binds to receptors on liver cells, it leads to the formation of glycogen from
glucose. This lowers the concentration of glucose in liver cells.

Explain how the formation of glycogen in liver cells leads to a lowering of blood glucose
concentration.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(2)

People with type II diabetes have cells with low sensitivity to insulin. About 80% of people with
type II diabetes are overweight or obese. Some people who are obese have gastric bypass
surgery (GBS) to help them to lose weight.

Doctors investigated whether GBS affected sensitivity to insulin. They measured patients’
sensitivity to insulin before and after GBS. About half of the patients had type II diabetes. The
other half did not but were considered at high risk of developing the condition.

The table below shows the doctors’ results. The higher the number, the greater the sensitivity to
insulin.
55
 
Mean sensitivity to insulin /
arbitrary units
(± SD)

Patients 1 month
Before
after
gastric
gastric
bypass
bypass
surgery
surgery

Did not have     0.55     1.30

diabetes (± 0.32) (± 0.88)

Had type II     0.40     1.10

diabetes (± 0.24) (± 0.87)

(b)     The doctors concluded that many of the patients who did not have type II diabetes were at
high risk of developing the condition.

Use the data in the table to suggest why they reached this conclusion.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(2)

(c)     The doctors also concluded that GBS cured many patients’ diabetes but that some were
not helped very much.

Do these data support this conclusion? Give reasons for your answer.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(3)

Q4. Diabetes is a disorder affecting the ability to control blood glucose concentration. One type of
diabetes can be due to an abnormality of the insulin receptors in the cell surface membranes of cells in
the liver and muscles. A high blood glucose concentration and the presence of glucose in the urine are
signs of this type of diabetes.

(a)     (i)      Suggest one way in which the insulin receptors might be abnormal.

56
 ______________________________________________________________

______________________________________________________________
(1)

(ii)     Explain how the presence of abnormal insulin receptors results in a high blood
glucose concentration.

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________
(2)

(iii)     Explain how the kidneys normally prevent glucose appearing in the urine of a non-
diabetic person.

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________
(3)

(b)     Twin studies have been used to determine the relative effects of genetic and
environmental factors on the development of this type of diabetes. The table shows the
concordance (where both twins have the condition) in genetically identical and genetically
non-identical twins.
 
Concordance in Concordance in
genetically identical genetically non-
twins / % identical twins /%

85 35

(i)      What do the data show about the relative effects of environmental and genetic
factors on the development of diabetes?

______________________________________________________________

______________________________________________________________
(1)

(ii)     Suggest two factors which should be taken into account when collecting the data in
order to draw valid conclusions.

1. ____________________________________________________________

57
 ______________________________________________________________

2. ____________________________________________________________

______________________________________________________________
(2)

Q5. Exenatide is a drug used for treating Type 2 diabetics. Scientists investigated the effects of
exenatide on insulin production.

The scientists used three groups of volunteers who were treated in the following ways.

Group 1: healthy, non-diabetics who were injected with exenatide in salt solution
Group 2: Type 2 diabetics who were injected with exenatide in salt solution
Group 3: Type 2 diabetics who were injected with salt solution.

Three hours after these injections, the scientists injected the same amount of glucose into the
blood of each volunteer.
The scientists measured the rate of insulin production by each person before and after injecting
the glucose.

(a)     (i)      Group 1 and Group 3 were control groups in this investigation.

Explain why each group was used.

Group 1 _______________________________________________________

______________________________________________________________

Group 3 _______________________________________________________

______________________________________________________________
(2)

(ii)     The scientists measured the rates of insulin production per unit body mass.

Explain why.

______________________________________________________________

______________________________________________________________
(1)

(b)     The graphs show the mean rates of insulin production for each group.

58
  

Suggest how exenatide could help people with Type 2 diabetes.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

(Extra space) ________________________________________________________

___________________________________________________________________

___________________________________________________________________
(3)

Q6. There are two types of diabetes: type 1 and type 2.

•        People with type 1 diabetes do not produce enough insulin.
•        People with type 2 diabetes do produce insulin but have cells which do not respond to
insulin.

Doctors use a glucose tolerance test to help diagnose people with diabetes. They start each
test after a person has not eaten overnight. They measure a person’s blood glucose
concentration.
59
 The person then drinks a solution containing 75 g of glucose. The doctors measure the person’s
blood glucose concentration 2 hours later. During the test, the person remains at rest.

Figure 1 shows three diagnoses that can be made from the results of the test.

Figure 1 – glucose tolerance test results and diagnoses

 
Blood glucose
concentration after 2 hours Diagnosis Comments
/ mg 100 cm–3

≤ 110 Non-diabetic Low risk for future diabetes

High risk for future diabetes.

Some doctors recommend that the
Between 140 and 200 Pre-diabetic
upper value should be lowered to
180 mg 100 cm–3

≥ 200 Diabetic Confirm by doing a second test

A researcher monitored the mean blood glucose concentration of a non-diabetic, a pre-diabetic

and a diabetic after they had each eaten a midday meal.

His results are shown in Figure 2.

Figure 2

(a)     People with type 1 diabetes are described as being insulin-dependent.

Suggest why they are described as insulin-dependent.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(1)
60
(b)     Some people with type 2 diabetes have cells which do not respond to insulin.
Explain how this leads to a reduced ability to regulate blood glucose concentration.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(3)

(c)     During a glucose tolerance test the person remains at rest.

Why is it important that the person remains at rest?

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(2)

(d)     Use Figure 2 to calculate how many times the maximum mean blood glucose
concentration of the pre-diabetic is greater than the maximum of the non-diabetic person.
Show your working.

Answer =____________________
(2)

(e)     Give three differences between the method used by the researcher to obtain the results
in Figure 2 and the method doctors use to carry out a glucose tolerance test.

1. _________________________________________________________________

___________________________________________________________________

2. _________________________________________________________________

61
 ___________________________________________________________________

3. _________________________________________________________________

___________________________________________________________________
(3)

(f)     Some doctors have recommended that the upper value used in the glucose tolerance test
should be lowered to 180 mg 100 cm–3.
Using information from Figure 1 and Figure 2, suggest why.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(3)

Homework

Revise for end of topic test!!

62